New York State of Health Assistor Online Certification

New York State of Health Assistor Online Certification Training Program

Additional Course Information Must click through all buttons where required Can review past sections and modules at any time Resources section in each module Assessments Certification directly related to completion of these modules and passing the assessments

ROAD TO CERTIFICATION

Module 1 Introduction to the Affordable Care Act (ACA) and Your Role

This module will help you inform consumers about key features of the ACA, and help you understand your role as an Assistor This mo dule provides a overview n of: • Featur es of the Affordab l Act (ACA e Care ) • Your r ole as an Assistor • Impor tance of the ACA and you role r

Section 1 The Aff Car orda e A ble (AC ct A)

Goals of ACA GOAL #1: Increase access to health care coverage for all Americans New Protections GOAL #2: Introduce new protections for people who already have health insurance

Goal 1: Increasing Access for All Americans • Click each topic to learn more about the ways that the ACA helps Americans gain access to health care coverage. You must click on all topics before moving on. Medicaid Expansion Creation of Federal Subsidies for Individuals Coverage for Young Adults Creation of the Small Business Marketplace Creation of the Marketplace Creation of Small Business Tax Credits

Goal 2: Protection for People with Health Insurance • Why would someone need protection? I couldn’t get coverage because I had breast cancer 15 years ago I had to pay more because I’m a woman. I had a heart attack. My insurance would only cover a certain amount of my healthcare expenses.

Goal 2: Protection for People with Health Insurance Click on each topic to learn more about the ways that the ACA protects people with health insurance. You must click on all topics before moving on. Essential Health Benefits Denying Coverage for Pre-Existing Conditions Discrimination Prohibited Annual and Lifetime Dollar Amounts Eliminated Text for rollovers to go here

When did all of this happen? ACA Timeline Marketplace went live First open enrollment period began ACA signed into law October 1, 2013 March 23, 2010 Coverage for all new plans began New York’s Marketplace established April – December 2012 January 1, 2014

Renee is a 43 year old woman who meets with you to get assistance with enrolling in health insurance. She asks you “what is the ACA? ” Choose how you would respond. Practice q The ACA makes sure that all Americans have access to health insurance that meets their needs and that they can afford, no matter their race, gender or health status. q The ACA means that some people can access health insurance, which works like it did before except that now insurance companies can’t deny people coverage if they are already sick. q The ACA ensures that everyone who cannot afford health insurance can enroll in Medicaid.

Insurance Requirements • “Individual Mandate” • No insurance = tax penalty • Plans must meet “minimum essential coverage” • Exemptions are available for certain individuals • It is not illegal to not have health insurance, just may have to pay penalty

Section 2 You r Ro an Ass le as isto r

Your Role as a NY State of Health Assistor Click on each item to learn more about the knowledge and skills required to be an assistor. Knowledge of the ACA Knowledge of the enrollment process Knowledge of the types of health insurance and plans Customer Service Skills

Section 3 Imp orta the nce o and ACA f Ass isto rs

1. In 2007, 3 years before the ACA was signed into law, what percentage of declared bankruptcies in the United States were medical-related? 70% 60% 50% 40% 30% 20% 10% 0% 24% 38% 50% 61% Source: Himmelstein, D. , Thorne, D. , Warren, E. , & Woolhandler, S. (n. d. ). Medical Bankruptcy in the United States, 2007: Results of a National Study. The American Journal of Medicine, 741 -746.

2. What percentage of New Yorkers who enrolled through the Marketplace in the 2015 open enrollment period reported that they had no health insurance when they applied? 100% 90% 89% 70% 60% 50% Correct! 40% 30% 20% 10% 0% The ACA aims to get as many Americans insured as possible, and 89% of New York consumers who enrolled through the Marketplace reported that they had no coverage when they applied. 35% 55% 75% 89% 95% Source: NY State of Health: The Official Health Plan Marketplace. (2015). 2015 Open Enrollment Report. Retrieved from http: //info. nystateofhealth. ny. gov/sites/default/files/2015%20 NYSOH%20 Open%20 Enrollment%20 Report. pdf

3. Which of the following is a feature(s) of the ACA? A. Free preventive services (e. g. , wellness visits, immunizations, screenings) B. No discrimination against consumers with pre-existing conditions Source: “Healthcare. gov. ” www. healthcare. gov D. All of the above C. Coverage for children on a parent’s plan, up to age 26

4. How many New Yorkers who enrolled in a health plan in the first year of the ACA worked with an inperson assistor? 70 60 49% 50 Your job is so important! In New York, over 2. 1 million consumers have enrolled in the online Marketplace, and there is a high demand for in-person assistance when applying for health plans: 49% of people who enrolled in a health plan in New York in the first year of the ACA worked with an Assistor. In year two, that number was 67%! 40 30 Correct! 20 10 0 13% 25% 36% 49% 67% Source: NY State of Health: The Official Health Plan Marketplace. (2015). 2015 Open Enrollment Report. Retrieved from http: //info. nystateofhealth. ny. gov/sites/default/files/2015%20 NYSOH%20 Open%20 Enrollment%20 Report. pdf & NY State of Health: The Official Health Plan Marketplace. (2014). 2014 Open Enrollment Report. Retrieved from http: //info. nystateofhealth. ny. gov/sites/default/files/NYSOH%202014%20 Open%20 Enrollment%20 Report_0. pdf

5. By the close of the 2014 -15 Open Enrollment period, how many New Yorkers reported that they are using their coverage? 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 0. 4 0. 58 0. 7 Source: NYS Health Foundation. (2014). New Yorkers Overwhelmingly Satisfied with Health Reform Coverage. Retrieved from http: //nyshealthfoundation. org/newsevents/new-yorkers-overwhelmingly-satisfied-with-health-reform-coverage 0. 84

Importance of ACA & Assistors • New Yorkers: – Need and want health insurance – Use their plans – Are satisfied with their plans • Your role as an Assistor is crucial to: – Clarify information – Answer questions – Assist consumers with applying for health insurance – Assist consumers with selecting a health plan that will meet their needs

u o y , e l u d o m s i h t : n t u • I o b a d e n r lea of the es r u t a e –F ACA e l o r r u e h t – Yo f o ce n a t r o – Imp nd your role ACA a Module Recap d to e e c o r p Please xt module the ne